全膝关节置换术中需要切除多少胫骨？
How much tibial resection is required in total knee arthroplasty?
机构信息
LVR Klinik für Orthopädie, Horionstrasse 2, 41749, Viersen, Germany.
出版信息
Int Orthop. 2011 Jul;35(7):989-94. doi: 10.1007/s00264-010-1025-5. Epub 2010 May 9.
Abstract
The purpose of our study was to calculate the optimal tibial resection depth in total knee arthroplasty. The data from 464 navigated total knee arthroplasties were analysed. An implant with a minimum insert thickness of 8 mm was used. Data regarding leg axis, joint line, insert thickness and tibial resection depth were recorded by the navigation device. An algorithm was developed to calculate the optimal tibial resection depth. The required tibial resection significantly correlates with the preoperative leg axis (p < 0.001). In valgus deformities the required resection depth averaged 5.1 mm and was significantly reduced compared to knees with a neutral leg axis (6.8 mm, p < 0.001) and varus deformities (8.0 mm, p < 0.001). Manufacturers recommend undercutting the high side of the tibial plateau to the depth of the thinnest insert available. However, our study demonstrates that in valgus deformities a reduced tibial resection depth is preferable. Hence, unnecessary bone loss can be avoided.
摘要
我们的研究目的是计算全膝关节置换术中胫骨切除的最佳深度。对 464 例导航全膝关节置换术的数据进行了分析。使用了最小插入厚度为 8 毫米的植入物。导航设备记录了有关腿部轴线、关节线、插入物厚度和胫骨切除深度的数据。开发了一种算法来计算最佳的胫骨切除深度。所需的胫骨切除深度与术前腿部轴线显著相关（p<0.001）。在外翻畸形中，所需的切除深度平均为 5.1 毫米，与中立位腿部轴线（6.8 毫米，p<0.001）和内翻畸形（8.0 毫米，p<0.001）相比显著降低。制造商建议将胫骨平台的高侧切至可用的最薄插入物的深度。然而，我们的研究表明，在外翻畸形中，较低的胫骨切除深度是可取的。因此，可以避免不必要的骨质流失。
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